A gracious note, letting a doctor know she made a difference

Several years ago, a young woman I’d been seeing in clinic weekly for about a month to initiate treatment for depression called late Friday afternoon to cancel an upcoming appointment for the following Monday and did not reschedule. The receptionist sent me a message as is our policy for patients who cancel and do not reschedule. It gave me a bad feeling that she was not following through on her treatment plan and I was uneasy about the upcoming weekend without knowing what was going on with her.

I could have just put on my coat and headed home at the end of that long Friday but decided to call my patient. She didn’t answer her phone. I mulled over my options, looked up her apartment address and drove there. As I stood by her door, I could hear someone moving around in her apartment, but there was no response to my knocks or my voice.

I decided to stay right there, knowing she was on the other side listening, talking to her through the door for about 15 minutes, letting her know I wasn’t leaving until she unlocked it and came out. I finally told her she could decide to open the door or I would call 911 and ask the police to come to make sure she was okay.

She finally opened the door, tears streaming down her face. She had been drinking heavily, with liquor bottles strewn around on the floor. She admitted an intent to overdose on aspirin and vodka. The vodka was already consumed but the unopened aspirin bottle was in her hand. I was the last person she had expected to see at her door.

I called the mental health unit at the local hospital and they had an open bed. I told my patient that we could save time and hassle of an emergency room evaluation by heading over right then and there.

She agreed to come with me and be admitted voluntarily for stabilization. I went the following day to visit her and she greeted me with a hug and thanked me for not giving up on her when she had given up on herself. In sobriety, her eyes were brighter and she was more hopeful. She never expected anyone to care enough to come looking for her, and to stand firmly by when she was rebuffing any approach. She was astounded and grateful, and frankly, so was I.

Recently a small card arrived in my clinic mailbox on a most challenging and frustrating (over)work day, from an unfamiliar address two thousand miles away. The name looked vaguely familiar to me but when I opened and read the contents, this time it was my turn to let tears flow:

Dear Doctor,

I am not sure if you will remember me considering you see a number of patients daily; however, I am a patient whose life you changed in the most positive way. I never truly thanked you for listening to me and hearing my silent words of grief and hearing my cries for help. If it had not been for you, had you not knocked on my door, I would not be writing this letter to you today. I don’t know exactly what to say to the person who saved me from hurting myself fatally. You were a stranger in my life, but a dear friend in my time of need. Thank you, for everything that you did for me. You have a permanent place in my heart, you have given my spirit hope, you have reminded me that a life is worth living. Thank you, thank you, thank you! Sincerely, L_____

I’m grateful I had the sense to go knock on her door, the stubbornness to stay put until she responded, and most of all, I’m appreciative for her gracious note letting me know it made a difference.

On a most difficult day as I struggled in my role as a healer and care provider, she made a difference for me.

She, in sensing my need, knocked on my door and I have opened it, awash in my own tears.

A gracious note, letting a doctor know she made a difference 6 comments

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Steve

Awesome story- what you do matters and you truly went above and beyond for that patient.
Can I comment about one part of the story that I find incredible- that you were able to get a patient admitted directly to a psychiatric facility without the standard unnecessary and low yield ED workup? I have literally never heard of this happening no matter how healthy the patient is or what the situation was. Even more incredible- she was intoxicated and was still able to be admitted. Does this hospital have its own ability to do these screenings?
Please don’t take this to mean that I do not like taking care of these patients in the ED or that I have bias against them. I believe that a crowded and noisy ED where they are subjected to unnecessary testing is the last thing these patients need. We need more of the model that you just suggested when it is obvious that there is no organic cause to the patent’s psychiatric issues.
Great story- thanks for sharing
Steve

http://briarcroft.wordpress.com/ Emily Gibson

Steve, this took place 7 years ago, and I worked on the inpatient behavioral health unit, as well as with outpatients in the community so had privileges to directly admit. These days, this would no longer be possible in our community hospital — very unlikely there would be available beds, an uninsured patient would need to go through significant paperwork review and the intoxication would mean being held in a secure bed in the ER for 8-12 hours for assessment while sober. So you are right, this was a humane and compassionate way to handle this that no longer is available to most patients and their providers.

Kristy Sokoloski

What a truly special post. Thank you for sharing this. This is such a good example of showing the positive that a Primary Care Physician can do for their patients. We need more stories that show the positive in addition to the stories that talk about the struggles that are currently going on in this field.